Provider Demographics
NPI:1487847984
Name:WU, VIRASENI (RN NP)
Entity Type:Individual
Prefix:MR
First Name:VIRASENI
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6627
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-6627
Mailing Address - Country:US
Mailing Address - Phone:310-753-2680
Mailing Address - Fax:
Practice Address - Street 1:1241 E DYER RD STE 145
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5694
Practice Address - Country:US
Practice Address - Phone:888-306-0615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA262207163W00000X
CA8539363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse